After Chapter 6.2, you will be able to:
Psychologists generally agree that we are not born with our self-concept and identity in place and fully developed. As young children, our identities are largely defined by our relationship to our parents. As we move into adolescence, we begin to develop into unique individuals, deciding who we want to be when on our own. Several theorists have proposed stages through which we develop. They vary in scope with respect to both the aspects of our identity they describe and their time span, but they all have one thing in common: the MCAT loves to test on them!
Sigmund Freud was a pioneer in charting personality and emotional growth. For Freud, human psychology and human sexuality were inextricably linked. In fact, Freud made the assertion that far from lying dormant until puberty, the libido (sex drive) is present at birth. Freud believed that libidinal energy and the drive to reduce libidinal tension were the underlying dynamic forces that accounted for human psychological processes.
Though revolutionary at the time, Freud’s theories have largely been discredited. They do, however, provide an interesting window into the history of personality theory. Expect the MCAT to test these ideas from a historical context, usually prefaced by According to Freud’s theory of psychosexual development . . .
Freud hypothesized five distinct stages of psychosexual development, summarized in Table 6.1 at the end of this section. In each stage, children are faced with a conflict between societal demands and the desire to reduce the libidinal tension associated with different erogenous zones of the body. Each stage differs in the manner in which libidinal energy is manifested and the way in which the libidinal drive is met. Fixation occurs when a child is overindulged or overly frustrated during a stage of development. In response to the anxiety caused by fixation, the child forms a personality pattern based on that particular stage, which persists into adulthood as a functional mental disorder known as a neurosis.
Freud’s stages of psychosocial development are based on the same principles as drive reduction theory, as discussed in Chapter 5 of MCAT Behavioral Sciences Review: libidinal energy creates internal tension, which we aim to reduce through certain behaviors.
The first stage is the oral stage (0 to 1 year). During this stage, gratification is obtained primarily through putting objects into the mouth, biting, and sucking. Libidinal energy is centered on the mouth. An orally fixated adult would likely exhibit excessive dependency.
Next is the anal stage (1 to 3 years), during which the libido is centered on the anus and gratification is gained through the elimination and retention of waste materials. Toilet training occurs during this stage. Fixation during this stage would lead to either excessive orderliness (anal-retentiveness) or sloppiness in the adult.
The phallic or Oedipal stage (3 to 5 years) centers on resolution of the Oedipal conflict for male children or the analogous Electra conflict for female children. In Freud’s view, the male child envies his father’s intimate relationship with his mother and fears castration at his father’s hands. He wishes to eliminate his father and possess his mother, but the child feels guilty about these wishes. To successfully resolve the conflict, he deals with his guilty feelings by identifying with his father, establishing his sexual identity, and internalizing moral values. Also, the child to a large extent de-eroticizes, or sublimates his libidinal energy. This may be expressed through collecting objects or focusing on schoolwork. Freud did not elaborate much on the Electra complex, although he theorized a similar desire. Because females cannot have castration fear (instead, they are thought to have penis envy), girls are expected to exhibit less stereotypically female behavior and be less morally developed in this theory.
Once the libido is sublimated, the child has entered the stage called latency, which lasts until puberty is reached.
For Freud, the final stage is the genital stage, beginning in puberty and lasting through adulthood. According to Freud, if prior development has proceeded correctly, the person should enter into healthy heterosexual relationships at this point. However, if sexual traumas of childhood have not been resolved, such behaviors as homosexuality, asexuality, or fetishism may result.
| Stage | Description |
| Oral | Libidinal energy centered on the mouth; fixation can lead to excessive dependency |
| Anal | Toilet training occurs during this time; fixation can lead to excessive orderliness or messiness |
| Phallic | Oedipal or Electra conflict is resolved during this stage |
| Latency | Libido is largely sublimated during this stage |
| Genital | Begins at puberty; if previous stages have been successfully resolved, the person will enter into normal heterosexual relationships |
Erik Erikson’s stages of personality development are based on a series of crises that derive from conflicts between needs and social demands. As such, psychosocial theory emphasizes emotional development and interactions with the social environment. According to Erikson, it is possible to fail at resolving the conflict central to any given stage of development, but this does not mean that mastery of each stage is required to move on to the next. Instead, Erikson viewed successful resolution of a stage, marked by answering an essential existential question, to imbue an individual with skills and traits that are carried through subsequent stages. Erikson’s stages are summarized in Table 6.2 at the end of this section.
The first such conflict is that of trust vs. mistrust (0 to 1 year). If resolved successfully, the child will come to trust his environment as well as himself. If mistrust wins out, the child will often be suspicious of the world, possibly throughout his life.
The second conflict is autonomy vs. shame and doubt (1 to 3 years). The favorable outcome here is feeling able to exert control over the world and to exercise choice as well as self-restraint. The unfavorable outcome is a sense of doubt and a persistent external locus of control.
The next conflict confronted is initiative vs. guilt (3 to 6 years). Favorable outcomes include a sense of purpose, the ability to initiate activities, and the ability to enjoy accomplishment. If guilt wins out, the child will be so overcome by the fear of punishment that the child may either unduly restrict himself or may overcompensate by showing off.
If the conflict of industry vs. inferiority (6 to 12 years) is resolved favorably, the child will feel competent, be able to exercise his or her abilities and intelligence in the world, and be able to affect the world in the way that the child desires. Unfavorable resolution results in a sense of inadequacy, a sense of inability to act in a competent manner, and low self-esteem.
During adolescence (12 to 20 years), the conflict of identity vs. role confusion emerges. This stage encompasses what Erikson termed physiological revolution. The favorable outcome is fidelity, the ability to see oneself as a unique and integrated person with sustained loyalties. Unfavorable outcomes are confusion about one’s identity and an amorphous personality that shifts from day to day.
The conflict of identity vs. role confusion has some positive effects: teenagers identifying their interests, gravitating toward friends who share these interests, and creating a sense of whom they want to be. On the other hand, this conflict can lead to the formation of cliques, bullying, and significant peer pressure. The increase of online and in-person bullying among adolescents has led to a number of programs to ease this crisis, such as StopBullying.gov and the It Gets Better campaign.
The main crisis of young adulthood (20 to 40 years) is intimacy vs. isolation. Favorable outcomes are love, the ability to have intimate relationships with others, and the ability to commit oneself to another person and to one’s own goals. If this crisis is not favorably resolved, there will be an avoidance of commitment, alienation, and distancing of oneself from others and one’s ideals. Isolated individuals are either withdrawn or capable of only superficial relationships with others.
The conflict of middle age (40 to 65 years) is generativity vs. stagnation. The successful resolution of this conflict results in an individual capable of being a productive, caring, and contributing member of society. If this crisis is not overcome, one acquires a sense of stagnation and may become self-indulgent, bored, and self-centered with little care for others.
Finally, old age (above 65 years) brings about the crisis of integrity vs. despair. If favorably resolved, we will see wisdom, which Erikson defined as detached concern with life itself, with assurance in the meaning of life, dignity, and an acceptance of the fact that one’s life has been worthwhile, along with a readiness to face death. If not resolved favorably, there will be feelings of bitterness about one’s life, a feeling that life has been worthless, and at the same time, fear over one’s own impending death.
| Erikson’s Stage (Crisis) | Age | Existential Question |
| Trust vs. mistrust | 0 to 1 year | Can I trust the world? |
| Autonomy vs. shame and doubt | 1 to 3 years | Is it okay to be me? |
| Initiative vs. guilt | 3 to 6 years | Is it okay for me to do, move, and act? |
| Industry vs. inferiority | 6 to 12 years | Can I make it in the world of people and things? |
| Identity vs. role confusion | 12 to 20 years | Who am I? What can I be? |
| Intimacy vs. isolation | 20 to 40 years | Can I love? |
| Generativity vs. stagnation | 40 to 65 years | Can I make my life count? |
| Integrity vs. despair | 65 years to death | Is it okay to have been me? |
Lawrence Kohlberg’s theory of personality development focuses not on resolving conflicts or urges, but rather on the development of moral thinking. Kohlberg reasoned that, as our cognitive abilities grow, we are able to think about the world in more complex and nuanced ways, and this directly affects the ways in which we resolve moral dilemmas and perceive the notion of right and wrong.
Kohlberg’s observations about moral reasoning were based on responses of subjects to hypothetical moral dilemmas. One often-cited example is the Heinz dilemma. In this scenario, a man named Heinz has a wife who is dying of a rare disease. There is a druggist in the town who invented a drug that could cure the disease. It costs him $200 to produce, yet he sells it for $2000. Heinz cannot afford this price, so he goes to the druggist and asks him if he would lower the price, a request that the druggist refuses. Desperate to save his wife, Heinz breaks into the druggist’s office one night and steals the medication. Kohlberg presented dilemmas such as this one to volunteers and asked them to explain whether the characters in the story acted morally and why or why not. Kohlberg wasn’t interested in the participants’ appraisal of the actions as right or wrong, as he believed either answer could be justified. Instead, he was far more interested in the reasoning behind the appraisal. Based on the participants’ responses, Kohlberg organized moral reasoning into six distinct stages ranging from the concrete to the abstract. He then organized these stages into three phases consisting of two stages each. Kohlberg’s stages are summarized in Table 6.3.
Preconventional morality, the first of these phases, is typical of preadolescent thinking and places an emphasis on the consequences of the moral choice. Stage one (obedience) is concerned with avoiding punishment (If I steal the drug, I’ll go to jail), while stage two (self-interest) is about gaining rewards (I need to save my wife because I want to spend more of my life with her). Stage two is often called the instrumental relativist stage because it is based on the concepts of reciprocity and sharing: I’ll scratch your back, you scratch mine.
The second phase is conventional morality, which begins to develop in early adolescence when individuals begin to see themselves in terms of their relationships to others. This phase is based on understanding and accepting social rules. Stage three (conformity) places emphasis on the “good boy, nice girl” orientation in which a person seeks the approval of others (I should not steal the drug because stealing is wrong). Stage four (law and order) maintains the social order in the highest regard (If everyone stole things they couldn’t afford, people who produce those items would not be able to continue their business).
Conventional morality corresponds to normal adult moral reasoning. Preconventional is therefore expected in children, and postconventional is expected in a smaller subset of adults with more advanced moral reasoning skills than the average population.
The third phase is postconventional morality, which describes a level of reasoning that Kohlberg claimed not everyone was capable of and is based on social mores, which may conflict with laws. Stage five (social contract) views moral rules as conventions that are designed to ensure the greater good, with reasoning focused on individual rights (Everyone has a right to live; businesses have a right to profit from their products). Finally, stage six (universal human ethics) reasons that decisions should be made in consideration of abstract principles (It is wrong for one person to hold another’s life for ransom).
Kohlberg viewed these stages as a progression in which each stage is adopted and then abandoned for the next as the individual progresses. In other words, we all begin in stage one and progress to varying degrees as our thinking matures.
Kohlberg is not without his critics. Some argue that postconventional morality describes views that are more prevalent in individualistic societies and is therefore biased against collectivist cultures. Similarly, Kohlberg’s research was only performed using male subjects, which may cloud differences in reasoning patterns between men and women.
| Phase | Age | Stages |
| Preconventional morality | Preadolescence | 1: Obedience 2: Self-interest |
| Conventional morality | Adolescence to adulthood | 3: Conformity 4: Law and order |
| Postconventional morality | Adulthood (if at all) | 5: Social contract 6: Universal human ethics |
Like Kohlberg, Lev Vygotsky’s work was focused on understanding cognitive development. For Vygotsky, the engine driving cognitive development was the child’s internalization of various aspects of the culture: rules, symbols, language, and so on. As the child internalized these various interpersonal and cultural rules, her cognitive activity developed accordingly.
Kohlberg and Vygotsky’s theories of cognitive development were both heavily influenced by Piaget’s work in this area, discussed in Chapter 4 of MCAT Behavioral Sciences Review.
Vygotsky is known for his concept of the zone of proximal development, referring to those skills and abilities that have not yet fully developed but are in the process of development. Gaining these skills successfully requires the help of a “more knowledgeable other,” typically an adult. For example, a child may struggle to ride a bicycle on her own, but with the help and guidance of a parent she may be successful. Vygotsky would say that this skill is currently within the child’s zone of proximal development.
Our personalities do not form in a vacuum; we are as much a product of those around us as a product of our own internal growth and development. Albert Bandura, who was also the psychologist behind the Bobo doll experiment described in Chapter 3 of MCAT Behavioral Sciences Review, claimed that observational learning contributes greatly to our future behaviors.
Young children observe and encode the behaviors they see in others, and may later imitate these behaviors. Children are more likely to imitate behaviors performed by someone who is like them: for example, young children will reliably mimic behaviors performed by their same-sex siblings. A child’s first models are her parents, but as the child grows and forms more relationships, other role models emerge. Siblings, teachers, and the media all play an important role in modeling behavior for a developing child, but by adolescence, peers become the most important role models in a person’s life.
As children grow, they become more able to see the identities of others as different from their own. They might experiment with other identities by taking on the roles of others, such as when children play house or school. Such role-taking is good practice for later in life, when a child begins to understand the perspectives and roles of others. Eventually, children become able to see how others perceive them and to imagine themselves from the outside. The ability to sense how another’s mind works—for example, understanding how a friend is interpreting a story while you tell it—is referred to as theory of mind. Once this ability has developed, we begin to recognize and react to how others think about us. We become aware of judgments from the outside world and react to these judgments. Our reactions to how others perceive us can be varied—maintaining, modifying, downplaying, or accentuating different aspects of our personality. This construct, which relies on others reflecting our selves back to ourselves, is appropriately called the looking-glass self.
A related concept is a reference group. Our self-concept often depends on whom we are comparing ourselves to. For example, as of 2012, the average annual salary for a physician in the United States was about $200,000. Compared to the national median household salary (approximately $50,000), these individuals were quite well off. However, only 11 percent considered themselves “rich.” Why? Many physicians live in higher socioeconomic areas, and their responses may thus be biased by comparison to those around them.